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Vo2 cardiopulmonary bypass

Samantha R Warnakulasuriya, David R Yates, Jonathan T Wilson, Michael Stone, Jonathan Redman, Simon Davies
BACKGROUND: Cardiopulmonary exercise testing (CPET) can identify patients at risk of adverse post-operative outcomes following major abdominal surgery including bariatric surgery. Scoring systems that also aim to predict post-operative outcome in this group include the validated obesity surgery mortality risk score (OSMRS). This study aims to investigate if CPET has additive value to other scoring systems in predicting post-operative outcomes following bariatric surgery. METHODS: Data was collected retrospectively on 398 patients who underwent CPET between October 2008 and April 2013...
September 16, 2016: Obesity Surgery
Samuele Baldasseroni, Alessandra Pratesi, Sara Francini, Rachele Pallante, Riccardo Barucci, Francesco Orso, Costanza Burgisser, Niccolò Marchionni, Francesco Fattirolli
OBJECTIVES: To assess the effect of cardiac rehabilitation (CR) and identify predictors of changes in functional capacity with CR in a consecutive series of older adults with a recent cardiac event. DESIGN: Observational. SETTING: In-hospital CR unit. PARTICIPANTS: Individuals aged 75 and older referred to an outpatient CR Unit after an acute coronary event (unstable angina pectoris, acute myocardial infarction) or cardiac surgery (coronary artery bypass grafting, heart valve replacement or repair) (N = 160, mean age 80 ± 4)...
August 2016: Journal of the American Geriatrics Society
Matthew G Browning, Robert L Franco, Jeffrey E Herrick, James A Arrowood, Ronald K Evans
BACKGROUND: Studies that have evaluated cardiopulmonary responses to exercise within the first few months of bariatric surgery have utilized cycle ergometry. However, walking is the most commonly reported mode of both pre- and post-operative PA. The divergent cardiopulmonary responses and metabolic costs of weight-bearing (walking) and non-weight-bearing (cycling) exercises warrant examination of the effects of bariatric surgery on cardiopulmonary responses during walking. METHODS: Nine women completed a maximal cardiopulmonary exercise test on a treadmill 2 weeks before and 3 months after gastric bypass surgery (GBS)...
June 20, 2016: Obesity Surgery
M V Zatevahina, A F Farzutdinov, A A Rahimov, I M Makrushin, G Y Kvachantiradze
UNLABELLED: The purpose of the study is to examine the perioperative dynamics of strategic blood oxygen transport indicators: delivery (DO2), consumption (VO2), the coefficient of oxygen uptake (CUO2) and their composition, as well as the dynamics of blood lactate indicators in patients with ischaemic heart disease (IHD) who underwent surgery under cardiopulmonary bypass with high thoracic epidural anaesthesia (HTEA) as the main component of anesthesia. MATERIALS AND METHODS: Research was conducted in 30 patients with a critical degree of operational risk, during the correction of post-infarction heart aneurysmn using the V...
September 2015: Anesteziologiia i Reanimatologiia
Marialena Mouzaki, Steven M Schwartz, Haifa Mtaweh, Gustavo La Rotta, Kandice Mah, Joann Herridge, Glen Van Arsdell, Christopher S Parshuram, Alejandro A Floh
BACKGROUND: Optimal energy provision, guided by measured resting energy expenditure (REE), is fundamental in the care of critically ill children. REE should be determined by indirect calorimetry (IC), which has limited availability. Recently, a novel equation was developed for estimating REE derived from carbon dioxide production (Vco2). The aim of this study was to validate the accuracy of this equation in a population of critically ill children following cardiopulmonary bypass (CPB)...
February 10, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Alejandro A Floh, Masayuki Nakada, Gustavo La Rotta, Kandice Mah, Joann E Herridge, Glen Van Arsdell, Steven M Schwartz
OBJECTIVES: To examine the association between cardiopulmonary bypass-related systemic inflammation and resting energy expenditure in pediatric subjects following cardiac surgery. DESIGN: Single-center, prospective cohort study. SETTING: Pediatric cardiac critical care unit in Toronto, Canada. PATIENTS: Children with congenital heart disease undergoing cardiopulmonary bypass surgery. INTERVENTIONS: Resting energy expenditure was determined by indirect calorimetry and the modified Weir equation, using VO2 and VCO2 measured by in-line respiratory mass spectrometry...
May 2015: Pediatric Critical Care Medicine
P J Hennis, P M Meale, R A Hurst, A F O'Doherty, J Otto, M Kuper, N Harper, P A Sufi, D Heath, H E Montgomery, M P W Grocott
BACKGROUND: For several types of non-cardiac surgery, the cardiopulmonary exercise testing (CPET)-derived variables anaerobic threshold (AT), peak oxygen consumption (VO2 peak), and ventilatory equivalent for CO(2) (VE/VCO2 ) are predictive of increased postoperative risk: less physically fit patients having a greater risk of adverse outcome. We investigated this relationship in patients undergoing gastric bypass surgery. METHODS: All patients (<190 kg) who were referred for CPET and underwent elective gastric bypass surgery at the Whittington Hospital NHS Trust between September 1, 2009, and February 25, 2011, were included in the study (n=121)...
October 2012: British Journal of Anaesthesia
Mineto Kamata, Toshiyuki Oda, Takeshi Nomura, Akira Yamasaki, Yutaka Takahama, Naoki Yabuta, Harumasa Nakazawa, Masanori Takahashi
BACKGROUND: The anesthetic management of Jehovah's Witnesses (JW) patients undergoing open heart surgery with cardiopulmonary bypass (CPB) is associated with a major risk of anemic hypoxia. METHODS: Fifteen patients from the community of JW underwent open heart surgery. The surgical procedures undertaken were aortic valve replacement in 7 patients, mitral valve plasty or replacement in 5 patients, repair of congenital heart diseases in 2 patients, and removal of left atrial myxoma in one patient...
March 2011: Masui. the Japanese Journal of Anesthesiology
Matthias Derwall, Roland C E Francis, Kotaro Kida, Masahiko Bougaki, Ettore Crimi, Christophe Adrie, Warren M Zapol, Fumito Ichinose
INTRODUCTION: Although inhalation of 80 parts per million (ppm) of hydrogen sulfide (H2S) reduces metabolism in mice, doses higher than 200 ppm of H2S were required to depress metabolism in rats. We therefore hypothesized that higher concentrations of H2S are required to reduce metabolism in larger mammals and humans. To avoid the potential pulmonary toxicity of H2S inhalation at high concentrations, we investigated whether administering H2S via ventilation of an extracorporeal membrane lung (ECML) would provide means to manipulate the metabolic rate in sheep...
2011: Critical Care: the Official Journal of the Critical Care Forum
Jia Li, Gencheng Zhang, Joann Herridge, Helen Holtby, Tilman Humpl, Andrew N Redington, Glen S Van Arsdell
OBJECTIVES: Cardiopulmonary bypass in infants results in a hypermetabolic response. Energy requirements of these patients have not been well studied. We assessed energy expenditure and caloric and protein intake during the first 3 days following the Norwood procedure. DESIGN: Clinical investigation. SETTING: Children's hospital. PATIENTS: Seventeen infants (15 boys, age 4-92 days, median 7 days). INTERVENTIONS: VO2 and VCO2 were continuously measured using respiratory mass spectrometry in 17 infants for the first 72 hrs following the Norwood procedure...
January 2008: Pediatric Critical Care Medicine
Jia Li, Gencheng Zhang, Lee Benson, Helen Holtby, Sally Cai, Tilman Humpl, Glen S Van Arsdell, Andrew N Redington, Christopher A Caldarone
BACKGROUND: After the Norwood procedure, early postoperative neonatal physiology is characterized by hemodynamic instability and imbalance of oxygen transport that is commonly attributed to surgical myocardial injury and a systemic inflammatory response to cardiopulmonary bypass (CPB). Because the Hybrid procedure (arterial duct stenting and bilateral pulmonary artery banding) avoids CPB, cardioplegic arrest, and circulatory arrest, we hypothesized that the Hybrid procedure is associated with superior postoperative hemodynamics and oxygen transport...
September 11, 2007: Circulation
Jia Li, Gencheng Zhang, Helen Holtby, Tilman Humpl, Christopher A Caldarone, Glen S Van Arsdell, Andrew N Redington
OBJECTIVES: The purpose of this study was to evaluate the effects of dopamine on hemodynamic status and oxygen transport in neonates after the Norwood procedure. BACKGROUND: Dopamine is widely used to augment cardiac performance and increase oxygen delivery (DO2) in patients after cardiopulmonary bypass (CPB). This might be at the expense of increased myocardial and systemic oxygen consumption (VO2), thus offsetting the improved DO2. This balance is particularly fragile in critically ill neonates...
November 7, 2006: Journal of the American College of Cardiology
Jia Li, Jacqueline Stokoe, Igor E Konstantinov, Rajesh K Kharbanda, Andrew N Redington
OBJECTIVE: We assessed the causes of imbalance of oxygen transport by continuously measuring oxygen consumption (VO2) during hypothermic cardiopulmonary bypass (CPB) in pigs. METHODS: Six pigs (17.2+/-1.6 kg) underwent hypothermic (32 degrees C) CPB for 180 min with 120 min of aortic crossclamping (ACC). An AMIS 2000 mass spectrometer was adapted for the on-line measurement of VO2. Arterial lactate was measured at the beginning of CPB, the end of hypothermia, before and 10 min after ACC release, 20 min later, and at the end of CPB...
September 2005: Perfusion
Tien-Yow Chuang, Wen-Hsu Sung, Chih-Yung Lin
OBJECTIVE: To determine whether, by using training enhanced by virtual reality (VR) displays, patients who had undergone coronary artery bypass graft (CABG) surgery could more effectively attain long-term cardiopulmonary results than those not using VR technology. DESIGN: Randomized controlled trial. SETTING: Exercise testing laboratory in a medical center. PARTICIPANTS: Consecutive sample of 32 patients who had undergone CABG surgery...
October 2005: Archives of Physical Medicine and Rehabilitation
Roel de Vroege, Wim Stooker, Wim van Oeveren, Edwin W M Bakker, Rien A J M Huybregts, Jan van Klarenbosch, Gerard J van Kamp, C Erik Hack, Leon Eijsman, Charles R H Wildevuur
During cardiopulmonary bypass (CPB), the brain and the kidneys may be damaged because of microemboli, ischemia, and inflammation. The latter has been reduced by the use of heparin coated circuits. We questioned whether heparin coated circuits could also reduce cerebral and renal damage and whether inflammatory markers correlate with damage to the brain and the kidneys. Fifty-one patients scheduled for coronary artery bypass grafting were perfused with either a heparin coated or an uncoated circuit. To compare the effect of a heparin coated circuit with an uncoated circuit upon cerebral and renal function in relation to inflammation, we assessed markers of cerebral (S100beta) and renal (N-acetyl-beta-D-glucosaminidase [NAG], creatinine, and urea) function, inflammation, and oxygen metabolism...
January 2005: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Jia Li, Andreas Hoschtitzky, Meredith L Allen, Martin J Elliott, Andrew N Redington
BACKGROUND: The balance between systemic oxygen consumption (VO2) and delivery (DO2) is impaired after cardiopulmonary bypass (CPB) and is related to systemic inflammatory response syndrome. We sought to assess VO2 and DO2 and their relationship with proinflammatory cytokines after CPB with the use of modified ultrafiltration (MUF) in infants. METHODS: Sixteen infants, aged 1-11.5 months (median, 6.3 months), undergoing hypothermic CPB with MUF were studied during the first 12 hours after arrival in the intensive care unit (ICU)...
October 2004: Annals of Thoracic Surgery
Luc Vanhees, An Stevens, Dirk Schepers, Johan Defoor, Frank Rademakers, Robert Fagard
BACKGROUND: Benefits of cardiac rehabilitation with exercise therapy are well-established, although individual reactions are heterogeneous. The identification of determinants of training effects is useful from a prognostic point of view, but data regarding this are scarce. Furthermore, limited data exist on the determinants of complications during exercise in cardiac patients. This study aimed to investigate the determinants (1) of training effects in cardiac rehabilitation and (2) of complications requiring resuscitation during exercise activities at the hospital and during continued exercise at a sports club for cardiac patients...
August 2004: European Journal of Cardiovascular Prevention and Rehabilitation
T L Lee, W K Boey, M L Woo, A Kumar, C N Lee, C Y Lee
To evaluate the surgical stress of open heart surgery with moderate hypothermic cardiopulmonary bypass (CPB), oxygen consumption (VO2), carbon dioxide production (VCO2), resting energy expenditure (REE), respiratory quotient (RQ), 24 hour-urinary urea nitrogen excretion (UUN), and glucose, fat and protein utilization were determined in 20 patients before and after open heart surgery. Proteins (albumin, prealbumin and transferin) and body weight were measured preoperatively and on 6th postoperative day (POD)...
April 1993: Journal of Anesthesia
R Peter Alston, Neil J Glassford, Amanda Torrie
Theoretically, systemic carbon dioxide (VCO2) production should be an alternative means to systemic oxygen uptake (VO2) for estimating the global efficacy of cardiopulmonary bypass (CPB). This study compared two methods of estimating VCO2: Fick's principle and oxygenator exhaust carbon dioxide (CO2) output. Both of these estimates were then compared with VO2. Fifty-one patients (39 male and 12 female) undergoing elective cardiac surgery requiring CPB were studied. Blood sampling was performed and measurements recorded during active cooling, environmental cooling/stable hypothermia and during rewarming...
November 2003: Perfusion
Yoshihiro J Akashi, Akira Koike, Kazuto Omiya, Naohiko Osada, Tomoko Maeda, Akihiko Tajima, Keiko Oikawa, Tadanori Aizawa, Hiroyuki Iinuma, Long-Tai Fu, Haruki Itoh
OBJECTIVES: Physical training in cardiac patients can increase exercise capacity and reduce plasma brain natriuretic peptide(BNP) concentration, but these effects may depend on the etiology of cardiac disease. The change in exercise capacity and BNP during the training period were investigated in patients with different cardiac diseases. METHODS: Ninety-one patients after coronary artery bypass grafting(CABG) and 78 patients after valve replacement (VR) underwent a symptom-limited incremental cardiopulmonary exercise test before (1 month) and 6 months after physical training...
August 2003: Journal of Cardiology
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